Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2021; 9(14): 3411-3417
Published online May 16, 2021. doi: 10.12998/wjcc.v9.i14.3411
Acute spontaneous thoracic epidural hematoma associated with intraspinal lymphangioma: A case report
Kai-Jay Chia, Li-Han Lin, Ming-Tse Sung, Tsung-Ming Su, Jin-Fu Huang, Hsiang-Lin Lee, Wen-Wei Sung, Tsung-Han Lee
Kai-Jay Chia, Tsung-Ming Su, Jin-Fu Huang, Tsung-Han Lee, Division of Neurosurgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
Li-Han Lin, Department of Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
Ming-Tse Sung, Department of Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
Hsiang-Lin Lee, Department of Surgery, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
Wen-Wei Sung, Department of Urology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
Author contributions: Chia KJ and Lee TH played a major role in the acquisition of data; Lin LH, Sung MT, Su TM, Huang JF and Lee HL interpreted the patient data; Chia KJ and Lee TH contributed in writing the manuscript; Lin LH, Sung MT, Sung WW and Lee TH revised the manuscript for intellectual content; all authors read and approved the final manuscript.
Informed consent statement: The patient has provided informed consent for publication of the case.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tsung-Han Lee, MD, PhD, Neurosurgeon, Division of Neurosurgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, No. 123 Dapi Road, Niaosong District, Kaohsiung 83301, Taiwan. tsunghan927@gmail.com
Received: December 3, 2020
Peer-review started: December 3, 2020
First decision: January 10, 2021
Revised: January 24, 2021
Accepted: March 20, 2021
Article in press: March 20, 2021
Published online: May 16, 2021
Abstract
BACKGROUND

Spontaneous spinal epidural hematoma is a rare neurosurgical emergency.

CASE SUMMARY

A 53-year-old healthy woman suffered from complete paraplegia in both legs and loss of all sensation below the xiphoid process. She was diagnosed as acute spontaneous thoracic epidural hematoma caused by an intraspinal lymphangioma. The primary lab survey showed all within normal limits. Presence of a posteriorly epidural space-occupying lesion at the T4-T8 level of the spinal canal was confirmed on magnetic resonance imaging. A decompressive laminectomy was performed from the T4 to T7 levels at the sixth hour following abrupt onset of complete paraplegia. The lesion was confirmed as lymphangioma. This patient recovered well within one month.

CONCLUSION

This study reports a case of acute spontaneous thoracic epidural hematoma caused by an intraspinal lymphangioma with well recovery after surgical intervention.

Keywords: Lymphangioma, Epidural hematoma, Intraspinal, Paraplegia, Decompressive laminectomy, Case report

Core Tip: This case suffered from acute spontaneous thoracic epidural hematoma caused by an intraspinal lymphangioma presenting with complete paraplegia in both legs and loss of all sensation below the xiphoid process. A posteriorly epidural space-occupying lesion at the T4-T8 level of the spinal canal was relieved via decompressive laminectomy in time and the symptoms recovered well within one month.